TIFFANY A.Y. PALMBACH, MS LMFT
NPI 1063478287, individual, Madison, WI, Marriage & Family Therapist
- 69% of Medicaid dollars are on codes with a history of abuse.
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | TIFFANY A.Y. PALMBACH, MS LMFT |
| Type | Individual |
| Status | Active |
| NPI issued | April 25, 2006, last updated February 17, 2014 |
| Practice location | 559 ZOR SHRINE PLACE, Madison, WI 53719, 608-833-0123 |
| Specialties | Marriage & Family Therapist (106H00000X, primary, license 674-124 WI) |
Procedures billed
The specific codes behind the dollars. Medicaid figures come from T-MSIS (2018 to 2024) and are compared with every other provider billing the same code; Medicare figures come from the 2024 physician and supplier file and compare this provider's submitted charge with what Medicare allowed, against the usual ratio for that code.
| code | what it is | paid | share | per patient-month | typical | rank among providers | |
|---|---|---|---|---|---|---|---|
| 97153 | Adaptive behavior treatment by protocol by technicianhistory of abuse | $2.5M | 42% | $977 | $2K (top 5% from $6K) | 38th percentile | |
| 97155 | Adaptive behavior treatment with protocol modification by QHPhistory of abuse | $1.6M | 27% | $589 | $512 (top 5% from $1K) | 62nd percentile | |
| 0365T | Adaptive behavior treatment by protocol each addl 30 min (pre-2019) | $804K | 14% | $1K | $2K (top 5% from $4K) | 27th percentile | |
| 0369T | Adaptive behavior treatment with protocol modification each addl 30 min (pre-2019) | $409K | 7% | $546 | $430 (top 5% from $971) | 65th percentile | |
| 0364T | Adaptive behavior treatment by protocol first 30 min (pre-2019) | $203K | 3% | $277 | $303 (top 5% from $1K) | 42nd percentile | |
| 97156 | Family adaptive behavior treatment guidance | $196K | 3% | $99 | $210 (top 5% from $547) | 19th percentile | |
| 0368T | Adaptive behavior treatment with protocol modification first 30 min (pre-2019) | $123K | 2% | $164 | $192 (top 5% from $534) | 39th percentile | |
| 0370T | Medicaid service code | $89K | 2% | $137 | $187 (top 5% from $354) | 20th percentile |
In this area
12 providers in Dane County, WI carry an indicator in the public record, with $4.2M at stake between them. The most common is more hours than a day holds, on 7 of them, followed by part of a provider network on 5.
| tier | provider | at stake | why |
|---|---|---|---|
| 3 | HOME HEALTH UNITED INC Madison, WI, ranked 1347 | $107K |
|
| 3 | OAKWOOD VILLAGE UNIVERSITY WOODS HOMES, INC Madison, WI, ranked 2061 | $0 |
|
| 3 | OAKWOOD VILLAGE PRAIRIE RIDGE HOMES, INC Madison, WI, ranked 3163 | $0 |
|
| 3 | CROSSROADS CARE CENTER OF SUN PRAIRIE LLC Sun Prairie, WI, ranked 4170 | $0 |
|
| 3 | BRISTOL HOSPICE - MADISON, L.L.C. Madison, WI, ranked 4617 | $0 |
|
| 5 | KIMBERLY KNIPPEL Madison, WI, ranked 9862 | $373K |
|
| 5 | JOSEPH PERRON Madison, WI, ranked 10134 | $891K |
|
| 5 | JANICE SCHOLZ Madison, WI, ranked 10560 | $1.3M |
|
Recent enforcement in WI
All releasesDepartment of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.
Referral packet
The packet is a draft for a reviewer. It reads every public record behind this case, states what the records show with a citation for each finding, names the regulation each finding relates to, and lists the ordinary explanations to rule out first. It never asserts intent.